Written by Jenny Birchall and Lizzie McCarthy, Women’s Aid December 2021 Thank you to all the survivors whose expertise and stories have informed the literature we have reviewed in this report. Thanks also to the staff at Women’s Aid for their help in compiling this report. Thank you to Ravi K. Thiara and Christine Harrison for their report which is published alongside this report and helps us ensure that our campaign is centred on the most marginalised survivor voices: Reframing the Links: Black and minoritised women, domestic violence and abuse, and mental health - A Review of the Literature. (Published by Women’s Aid, 2021) We are extremely grateful to the Gamesys Foundation for its funding support for this report and the #DeserveToBeHeard campaign. Please cite this report as: Women’s Aid. (2021) Mental health and domestic abuse: A review of the literature. Bristol: Women’s Aid 2 Women’s Aid Women’s Aid is the national charity working to end domestic abuse against women and children. Over the past 47 years, Women’s Aid has been at the forefront of shaping and coordinating responses to domestic abuse through practice, research and policy. We empower survivors by keeping their voices at the heart of our work, working with and for women and children by listening to them and responding to their needs. We are a federation of over 170 organisations which provide just under 300 local lifesaving services to women and children across the country. We provide expert training, qualifications and consultancy to a range of agencies and professionals working with survivors or commissioning domestic abuse services, and award a National Quality Mark for services which meet our quality standards. We hold the largest national data set on domestic abuse, and use research and evidence to inform all of our work. Our campaigns achieve change in policy, practice and awareness, encouraging healthy relationships and helping to build a future where domestic abuse is no longer tolerated. Our support services, which include our Live Chat Helpline, the Survivors’ Forum, the No Woman Turned Away Project, the Survivor’s Handbook, Love Respect (our dedicated website for young people in their first relationships), the national Domestic Abuse Directory and our advocacy projects, help thousands of women and children every year. www.womensaid.org.uk www.loverespect.co.uk 3 Women's Aid's new campaign Deserve To Be Heard aims to ensure that the mental health needs of women, who are all too often not listened to and not believed, are heard and responded to effectively. For more information go to: https://www.womensaid.org.uk/deservetobeheard/ 4 Contents Introduction............................................................................................. 8 Methodology............................................................................................ 9 Terminology........................................................................................... 11 Gaps in the literature..............................................................................14 Section One............................................................................................ 16 The link between domestic abuse and mental ill health.............................16 (a) The impact of domestic abuse on mental wellbeing.........................17 The pathologisation of survivor responses to domestic abuse...............................17 Domestic abuse is a key cause of women’s mental ill health.................................20 The weaponisation of mental illness by perpetrators.............................................21 (b) Intersecting forms of oppression and experiences of marginalised groups............................................................................. 22 Experiences of Black and minoritised survivors.....................................................23 Experiences of older and younger women.............................................................24 Pregnancy and maternity.......................................................................................25 Experiences of LGBTQ+ survivors..........................................................................25 Experiences of disabled survivors..........................................................................26 (c) The nature of mental health impacts................................................28 Impact on self-esteem....................................